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Title: Primary neurolymphomatosis diagnosed by spinal nerve root biopsy
Authors: Saunders, Samantha Louise;Giang, Samantha M;Sriweerawanidchakun, Sangruthai;Schutz, Anna 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: 22-Feb-2024
Source: Online ahead of print
Journal title: Practical Neurology
Department: Neurology
Abstract: Primary neurolymphomatosis is the direct infiltration of lymphomatous neoplastic cells into nerve roots and/or peripheral nerves. A 67-year-old man had a 24-month history of progressive and severe left lower limb neuropathic pain, ipsilateral ankle dorsiflexion weakness and gait disturbance. Gadolinium-enhanced MRI showed thickening and enhancement of the cauda equina, L5, S1 and S2 nerve roots. 18Fluorodeoxyglucose positron emission tomography showed concordant hypermetabolism. L5 nerve root biopsy confirmed diffuse large B-cell lymphoma. One cycle of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy resulted in remission, but this was not sustained. Primary neurolymphomatosis is rare and diagnostically challenging, and often the diagnosis is delayed. While biopsy is the gold standard for diagnosis, neuroimaging helps to characterise lesions and to determine the feasibility of biopsy.
DOI: 10.1136/pn-2023-003977
Publicaton type: Journal Article
Keywords: Neurology
Appears in Collections:Neurology

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